U.S. patent number 4,444,180 [Application Number 06/353,707] was granted by the patent office on 1984-04-24 for surgical instrument for engaging a bony part of the human body and guiding a drill bit into a specific location in the bony part.
This patent grant is currently assigned to Aktiebolaget Stille-Werner. Invention is credited to Lars G. B. Peterson, Gerhard Schneider.
United States Patent |
4,444,180 |
Schneider , et al. |
April 24, 1984 |
Surgical instrument for engaging a bony part of the human body and
guiding a drill bit into a specific location in the bony part
Abstract
A surgical instrument is provided for engaging a bony part of
the human body and guiding a drill bit into a specific location in
the bony part comprising, in combination, a pair of lever arms
pivotably attached at a point intermediate their ends; locking
means for locking the arms together in a fixed position with
respect to each other; means on each arm on the same side of the
pivot attachment for manipulating the arms in a swinging movement
about the pivot; each arm on the other side of the pivot attachment
being shaped so that the pair of arms can embrace the bony part
during an operation; one of the arms carrying on one end on said
other side a guide head having at least one through passage to
guide a drill bit and the other arm carrying at one end on the said
side an engagement head, the inner facing surfaces of the guide
head and engagement head being shaped to fixedly engage said bony
part, the through passage in the guide head being aligned along an
axis which in the operating position of the instrument with the
guide head and the engagement head engaging said bony part is
directed towards and within the dimensions of the engagement head,
so as to direct the drill bit to the selected specific location in
the bony part.
Inventors: |
Schneider; Gerhard (Alta,
SE), Peterson; Lars G. B. (Partille, SE) |
Assignee: |
Aktiebolaget Stille-Werner
(Stockholm, SE)
|
Family
ID: |
23390225 |
Appl.
No.: |
06/353,707 |
Filed: |
March 1, 1982 |
Current U.S.
Class: |
606/96 |
Current CPC
Class: |
A61B
17/1714 (20130101) |
Current International
Class: |
A61B
17/16 (20060101); A61B 17/17 (20060101); A61F
005/04 () |
Field of
Search: |
;128/92EB,92EA |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
Primary Examiner: Yasko; John D.
Claims
Having regard to the foregoing disclosure, the following is claimed
as the inventive and patentable embodiments thereof:
1. A surgical instrument for joining a ligament to a bony part of
the human body, by immovably engaging a bony part of the human body
and precisely guiding a drill bit into a specific precisely defined
location in the bony part, comprising, in combination, a pair of
lever arms pivotably attached at a point intermediate their ends;
locking means for locking the arms together in a fixed position
with respect to each other; means on each arm on the same side of
the pivot attachment for manipulating the arms in a swinging
movement about the pivot; each arm on the other side of the pivot
attachment being shaped so that the pair of arms can embrace the
bony part during an operation; one of the arms carrying immovably
and fixedly mounted on one end on said other side a guide head
having at least one through passage to guide a drill bit, and the
other arm carrying immovably and fixedly mounted at one end on the
said other side an engagement head having at least one opening
therethrough defining an open area corresponding to the specific
precisely defined location to be drilled into in the bony part; the
inner facing surfaces of the guide head and engagement head being
provided with a plurality of projections shaped to immovably and
fixedly engage said bony part, the through passage in the guide
head being aligned along an axis which in the operating position of
the instrument, with the guide head and the engagement head
engaging said bony part, is directed towards and within the
dimensions of the open area defined by the opening through the
engagement head, so as to precisely direct the drill bit along said
axis to the selected specific precisely defined location in the
bony part.
2. A surgical instrument according to claim 1 in which the guide
head has a plurality of parallel through passages.
3. A surgical instrument according to claim 1 in which the guide
head has a flat inner facing surface and the passage runs along an
axis perpendicular to the surface of the bony part.
4. A surgical instrument according to claim 1 in which the
engagement head is bifurcated and has two prongs which define
therebetween the dimensions within which the drill bit is directed
by the guide head.
5. A surgical instrument according to claim 4 in which one prong is
longer than the other prong.
6. A surgical instrument according to claim 1 in which the
engagement head is annular, having an opening which defines
therewithin the dimensions within which the drill bit is directed
by the guide head.
7. A surgical instrument according to claim 1 in which the
engagement head carries on its inner facing surface a plurality of
pins arranged to be pressed into the bony part.
8. A surgical instrument according to claim 1 in which the guide
head carries on its inner facing surface a plurality of pins
arranged to be pressed into the bony part.
9. A surgical instrument according to claim 1 in which both the
guide head and the engagement head carry on their inner facing
surfaces a plurality of pins arranged to be pressed into the bony
part.
Description
Surgical instruments for engaging bony parts of the human body and
guiding a drill bit towards a specific location in the bony part
have two pivotably attached lever arms, the end of one of which
carries a guide means for the drill bit, shaped with jaws for
clamping and holding together two sections of bone which are to be
joined together. One or several holes are drilled through the bone
sections, and then the bone sections are sewn together with
sutures. The guide means for the drill bit can be slidably or
pivotably mounted on the lever arm, and has one or several through
passages for the drill bit. However, the available instruments do
not permit alignment of the drill bit passage with sufficient
accuracy for the more precise operations, for example, when a
ruptured ligament is to be joined to a condyle.
The present invention provides a surgical instrument of this type,
which permits drilling of a passage in a bony part with extreme
precision, in any selected precisely aligned direction, and which,
in contrast to prior art devices can be locked onto the bony part,
for example, a condyle, in the most appropriate position for a
precision ligament or tendon transplant operation.
The surgical instrument in accordance with the invention is
arranged to engage a bony part of the human body and guide a drill
bit into a specific location in the bony part, and comprises, in
combination:
(1) a pair of lever arms pivotably attached at a point intermediate
their ends;
(2) locking means for locking the arms together in a fixed position
with respect to each other;
(3) means on each arm on the same side of the pivot attachment for
manipulating the arms in a swinging movement about the pivot;
(4) each arm on the other side of the pivot attachment being shaped
so that the pair of arms can embrace the bony part during an
operation;
(5) one of the arms carrying on one end on said other side a guide
head having at least one through passage to guide a drill bit;
and
(6) the other arm carrying at one end on the said other side an
engagement head;
(7) the inner facing surfaces of the guide head and engagement head
being shaped to fixedly engage said bony part;
(8) the through passage in the guide head being aligned along an
axis which in the operating position of the instrument, with the
guide head and the engagement head engaging said bony part is
directed towards and within the dimensions of the engagement head,
so as to direct the drill bit to the selected specific location in
the bony part.
A preferred embodiment of surgical instrument in accordance with
the invention is shown in the accompanying drawings, wherein:
FIG. 1 shows a perspective view of a surgical instrument of the
forceps type according to the invention;
FIG. 2 shows a perspective view from the opposite side of the
instrument shown in FIG. 1;
FIG. 3 illustrates in a simplified manner the attachment of a
tendon using the device of FIGS. 1 and 2;
FIG. 4 is a detail view of an engagement head according to the
invention in position engaging a bony part; and
FIG. 5 shows another embodiment of engagement head.
The surgical instrument shown in FIGS. 1 and 2 has lever arms or
forceps arms 1 and 2, desirably of stainless steel, joined together
by means of a pivot 3. The manipulative shanks 4 and 5 on one side
of the pivot pin 3 carry a conventional integral locking means
composed of a toothed arcuate rod 6 joined to the shank 4 and
extending towards the shank 5. The rod 6 interacts with a tooth
(not shown) on a projection 7 on the shank 5 extending towards the
shank 4. Locking takes place when the tooth on the projection 7
lies between two adjacent teeth on the rod 6, as the shanks 4 and 5
are pivoted towards each other by hand, manipulating the finger
grips 4a, 5a. The two shanks 8 and 9 on the other side of the pivot
3 are shaped with an outwardly extending bend large enough to
enable them to embrace a bony part such as part of a condyle.
Fixedly attached to the end 8a of the shank 8 is a guide head 10
with at least one, and in this case nine, straight through
parallel, cylindrical passages 11, 12, 13, sized to accomodate a
drill bit. The longitudinal axis of the central passage 11 is
marked in FIG. 1 by the line A. The opposite shank 9 has fixedly
attached at its end section an engagement head 14 which in the
illustrated embodiment is shaped as a fork with two prongs 15 and
16. Each prong has an inwardly curved end section, 17 and 18
respectively, extending towards the guide head 10. The end of each
prong has a pin 19 and 20, respectively, shaped to penetrate into
the bone tissue, and immovably hold the instrument against
displacement of the guide head 14 after the instrument has been
locked around the bony part, condyle or the like. The flat surface
of the guide head 10 facing the engagement head 14 is also provided
with four pins, 22, 23, 24, 25, also arranged to penetrate into the
bone tissue, to prevent the guide head 10 from sliding or turning
after the instrument has been locked to the condyle.
The pins 19, 20, 22, 23, 24, 25, can be replaced by other engaging
means, such as knurls, blunt-tipped projections, or ribs, but pins
are preferred.
In the position illustrated in FIGS. 1 and 2, the instrument is in
the open position, and has not been clamped around the bony part
into which the hole is to be drilled. However, in an operation on a
ligament injury, the surgical instrument according to the invention
is provided with shanks 8 and 9 of such a size that the axis A of
the through passages 11, 12, 13 will, in the locked position of the
instrument, lie between the pins 19 and 20, or within the open area
defined by the dimensions of the engagement head. Thus, in contrast
to what is possible with prior art instruments, it is very easy to
visually determine the entry opening and exit opening of the drill
bit passages, thereby ensuring that the drill bit passage or
passages will be in correct alignment, for example, for the
ligament or tendon transplant 26 which is to be attached to a
condyle 27. If the alignment of the drill bit passages is not
precise, the passages, for example, will direct the bit to points
28 and 29 instead of to the correct points 30 and 31, with the
result that the ligament or tendon transplant will be misaligned,
because the suture passing through the ligament or tendon
transplant is wrongly directed by the drilled holes.
Inasmuch as the engagement head 14 which is applied to the point of
attachment for the ligament or tendon transplant can be used to
"sight" the axis A, it is possible when attaching the instrument to
determine precisely the exact spot for drilling the hole in the
bony part and obtain the correct points 30 and 31 shown in FIG.
3.
FIG. 4 is a detail view of an engagement head attached to shank 9
that has two prongs 15' and 16' in engagement with a curved surface
of a bony part, one prong 15' being longer than the other prong
16', to ensure a better grip.
The engagement head may also be shaped as a ring, in which case the
axis A will be located within the central opening through the ring,
after the instrument has been clamped on. This ring may be
circular, square, rectangular or triangular in shape.
FIG. 5 illustrates a circular ring 14' whose opening B is in
alignment with axis A after the instrument has been clamped on the
bony part. If there are a plurality of passages in the guide head
10, then the axes for all of these passages must pass through the
opening B. The engagement surface of the engagement head 14' is in
this case provided with knurls 32, which afford a good grip in
combination with a tip 33.
The cylindrical guide head 10 need not be cylindrical, but can have
any desired cross-sectional configuration.
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